| NPI | 1093808446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 87662) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CO 40893) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2021-01-12 |